Abstract

Cost-Effectiveness of Therapeutic Drugs for the Prevention of Incident Vertebral Fracture in Patients with Postmenopausal Osteoporosis -Randomized Controlled Trial of 72 Week Follow-Up

Background: The importance of the treatment of osteoporosis is increasing in countries where the population age is rapidly advancing. A prospective study was planned for the purpose of determining the cost-effectiveness of various drugs for the prevention of incident vertebral fractures in patients with postmenopausal osteoporosis.

Method and Findings: Two hundred and forty women aged 65 to 75 years old who started treatment with various therapeutic drugs for primary postmenopausal osteoporosis were included in this study. The bone mineral density (BMD) of the lumbar spine estimated by the percent value of the young adult mean (%YAM) was less than 60% and all subjects were diagnosed with severe osteoporosis. Eight therapeutic drugs for osteoporosis were estimated of costeffectiveness to protect against incident vertebral fracture. The cost invested in our hospital to suppress one incident of vertebral fracture was 930,792 yen for daily parathyroid hormone (PTH), 872,004 yen for weekly PTH, 142,196 yen for denosumab, 195,4499 yen for monthly intravenous ibandronate, 192,234 yen for monthly minodronic acid hydrate,232,727 yen for monthly risedronate, 229,943 yen for weekly alendronate, and 352,639 yen for raloxifene. Denosumab was the most cost-effective drug, as seen from the suppression of incident vertebral fracture in severe osteoporotic patients with YAM value of less than 60% between 65 -75 years old.

Conclusion: Cost-effectiveness should be evaluated when choosing a therapeutic drug for patients with osteoporosis.